Parenthood is a uniquely transformative experience. With all the changes this brings about, it helps to be prepared beforehand for life with a newborn. From selecting a pediatrician, to what’s safe and what’s not when it comes to sleep, concerns on bonding, and why breastfeeding is so important, there’s much to learn about before baby arrives.

Dr. T. Jann Caison Sorey from Blue Cross Blue Shield of Michigan discusses all you need to know about this and more in her interview with Dreaming of Baby.

Daniela: Good afternoon, Dr. T. Jann Caison Sorey, and a warm welcome to Dreaming of Baby! We’re eager for our conversation with you today on what’s imperative for parents-to-be to know before their little one is born. Before we start with our discussion, grateful if you could introduce yourself to our readers. 

Dr. T. Jann Caison Sorey: Very nice to meet you. It’s a pleasure to be here. My name is Dr. T. Jann Caison Sorey, medical director, pediatrics and adolescent medicine, Blue Cross Blue Shield of Michigan. I’m pleased to be able to share some information with soon-to-be or new parents to help them be more comfortable. 

Factors to consider when selecting a pediatrician

Daniela: Great, thank you for the introduction! To start with, as parents do their research for selecting a pediatrician for their baby, what are the qualities or factors that should be prioritized?

Dr. T. Jann Caison Sorey: Parents should first look for someone who has wonderful credentials – when I say that I mean someone credentialed in their medical specialty, i.e. pediatrics. Additionally, someone with good old-fashioned bedside manner who will take the time to talk and explain things in an understandable way. It is important parents find someone they can build a trusting relationship with.  Lastly, the medical professional should be accessible during non-traditional hours. Availability beyond traditional hours gives parents access to their doctor if there is a need. This doesn’t necessarily mean physically in-office, just someone who can be contacted if something were to happen in the middle of the night, over the weekend or a holiday. I also recommend that parents consider a doctor who comes highly recommended by a friend, family member, or someone they respect.

Dr. T. Jann Caison Sorey: “the medical professional should be accessible during non-traditional hours. Availability beyond traditional hours gives parents access to their doctor if there is a need.”

Your newborn’s health – what to look out for.

Daniela: These are very helpful points to take into consideration, thank you. The first days with a new baby at home can turn out to be quite a challenge and nothing is quite normal for new parents. As parents look at their baby, what is regarded as normal?

Dr. T. Jann Caison Sorey: Well, we know parents are going to count all of their baby’s fingers and toes, but parents should look at the physical makeup of the child: color of their skin and eyes, and movement of the extremities. In most cases, the doctor will have alerted the parents about anything that they may need to keep an eye on. Notice how alert the baby is and how well they can briefly track (focus) on the faces of the parents. Parents should feel comfortable interacting with their baby so that the baby is well-aware of their presence and is comforted when held and consoled. It’s also important to note the shape of the baby’s head. Following his/her delivery through the birth canal, they may have a slightly elongated head and that will likely get better with time. If the parents remain worried, they should talk to the doctor about it. Peeling skin after birth occurs often as well and should get better after a few days.

Baby acne – should I be worried?

Daniela: We’ve had parents ask about baby acne. If baby acne does appear, is this worrying and how long does it usually last?

Dr. T. Jann Caison Sorey: It looks worrying, but typically it goes away over time. If parents are very worried about it, they should see the child’s pediatrician to track and monitor the acne; however, it will generally go away on its own.

Bonding with your newborn.

Daniela: Thank you. You also mentioned earlier interaction, and maybe on a related level: bonding with the baby. Many parents might be worried about this. Is this something that happens automatically? If not, how can parents bond with their baby?

Dr. T. Jann Caison Sorey: This is extremely important – it’s the comfort level between the parents and the child. There must be a sense of closeness between the baby and parents. Babies like being held; the warmth of the body and the sound of a heartbeat often makes babies feel comfy. There’s also a security that is instilled in the newborn through this bonding process, where they feel loved and secure. It’s not just touching the baby that is beneficial, it’s speaking to the baby and looking at him/her, showing smiling facial expressions, talking to the baby, or even softly singing – all of that is comforting. Responding to the needs of the child is important as well. Babies have no other way to communicate other than to cry. The timing of how and when the parent responds to the cry is very important.

Dr. T. Jann Caison Sorey: “Responding to the needs of the child is important as well. Babies have no other way to communicate other than to cry. The timing of how and when the parent responds to the cry is very important.”

Daniela: So, would you say that the crying-out method affects bonding negatively?

Dr. T. Jann Caison Sorey: The “crying it out method” is a suggested method of approach mainly for an older infant. It is a choice that suggests that you allow the child to cry longer if their needs are met and they are safe and fed.  It was suggested for parents who may be working with the guidance of their baby’s doctor’s advice to manage excessive crying when the baby is fine in all aspects. The “crying it out” method should only be used selectively and in collaboration with and at the recommendation of the child’s pediatrician. As the child gets older, there will be a recommendation to let a child self-soothe to fall asleep on their own, but parents should peek in from time to time and make sure everything is OK.

Daniela: Many thanks for clarifying that. Backtracking a little to the time of birth, how does skin-to-skin help bonding and what would be the recommended duration given that there are no complications?

Dr. T. Jann Caison Sorey: Skin-to-skin bonding is beneficial. As the parents learn more about their newborn, they will become more comfortable with how they want to bond with their baby, which can include skin-to-skin bonding choices as well as other bonding methodologies they are most comfortable with adopting.

Why breastfeeding is important

Daniela: Proceeding to another important subject, breastfeeding: We’ve certainly heard a lot about the importance of breastfeeding, but for parents-to-be weighing in their options, why exactly is breastfeeding so important?

Dr. T. Jann Caison Sorey: Breastfeeding is the best way for a newborn to be fed. First, it’s another opportunity for a mother to bond with her newborn, but equally as important, are all of the immunity benefits that are provided to the baby through the mother’s breastmilk. Breastfeeding over time fortifies the baby’s immune system. It is really one of the best ways a mother can protect her newborn. Formula-fed babies may not have the benefit of breast milk immunity exposure and as such, may be more susceptible to illness when compared with a breastfed baby. Also, the protein found in breastmilk tends to be much more easily digested by newborns as compared to formula. If, however, there are complications regarding breastfeeding, formula is a great option.

Daniela: If a mother-to-be’s milk comes in before the baby is born, would it be wise to express and safely store? Would this expressed milk provide the same immunity?

Dr. T. Jann Caison Sorey: In many cases, mothers do not experience significant amounts of breast milk production until the baby is born. However, it is possible. In those cases, the mother should check with her OBGYN to ensure all is normal and expected. In reference to colostrum, although it has nutritional value, I am not certain storing it prior to the baby’s birth would be beneficial.  Storage circumstances can vary with refrigerated or freezer temperatures and may interfere with the preservation of the properties of the colostrum.

Dr. T. Jann Caison Sorey: “Breastfeeding is the best way for a newborn to be fed. First, it’s another opportunity for a mother to bond with her newborn, but equally as important, are all of the immunity benefits that are provided to the baby through the mother’s breastmilk.”

What happens when breastfeeding is not possible?

Daniela: Thank you for clarifying. If breastfeeding is not possible, what happens then? Is there anything specific that parents should keep in mind when selecting formula?

Dr. T. Jann Caison Sorey: Most formulas have many of the same ingredients and properties, so essentially, parents may find that one may suit their baby more than another. The most important things to consider are whether or not the baby is tolerating the formula and if the baby is gaining a healthy amount of weight. Each child is different, so if a cow protein-based formula is not being accepted well, parents may want to try a soy-based or other formula combinations instead. There are different formulas specifically developed for premature babies as well and a pediatrician can help guide those decisions.

Daniela: When trying to find the best formula for their baby, can parents simply switch from one to another or is it a pediatrician who should be managing this?

Dr. T. Jann Caison Sorey: This should be done via collaboration between the parents and their pediatrician. Parents should trial a formula for at least one to two months or so (if supported by their doctor’s recommendation, and by weight gain as well as growth benefit by their newborn) before deciding to switch to another type so that they can effectively determine which is most beneficial for their child. Weight gain is typically the best way to measure benefit.

Baby sleep patterns

Daniela: Proceeding to sleep (which may not come in tons for new parents). Whilst aware that each baby is unique, what would typical newborn sleeping patterns look like?

Dr. T. Jann Caison Sorey: Newborn sleeping patterns can be all over the board. Initially, they will wake up at least every two to three hours as they become hungry. Sleeping is relative to the baby, but most will sleep for a significant period throughout the day.

How to limit the risk of SIDS

Daniela: Even thinking of Sudden Infant Death Syndrome (SIDS) is scary, let alone experiencing it. What should parents-to-be keep in mind when purchasing a crib and what should they be giving attention to once baby is born and they’re putting the little one to sleep?

Dr. T. Jann Caison Sorey: The crib is very important. It should meet the guidelines of the current safety standards. Avoid older, hand-me-downs because of the risk of injury/strangulation/suffocation. Also, check online for brand recalls before purchasing. Do not purchase/acquire cribs that are on the recall list.  It is important to make sure that the crib is fitted with a tight bed sheet and does not contain anything else inside the crib.  This means no stuffed animals, toys, bumpers, pillows or blankets! Babies should always be put to sleep on their back!

Daniela: And until what age should babies be sleeping on their back?

Dr. T. Jann Caison Sorey: As babies grow and get older, they will master the developmental task of rolling over on their own, but still, the crib should be kept empty of stuffed animals, toys, bumpers, blankets, pillows, etc. It’s important to continue to keep a close eye on them once they’re able to roll over and try to turn them on their back again. Babies should not be sleeping on a couch or in bed with their parents/siblings where suffocation can easily occur. Sharing a room with the baby is beneficial to stay close to them, but they should never share a bed.

Dr. T. Jann Caison Sorey: “Babies should not be sleeping on a couch or in bed with their parents/siblings where suffocation can easily occur.”

Daniela: So, for the parents-to-be thinking of co-sleeping, this would increase the risk of SIDS?

Dr. T. Jann Caison Sorey: That should absolutely not be done. There would be a very HIGH risk for SIDS.

Newborn Screening/Developmental Assessment

Daniela: Thank you. Moving on to another subject, can you tell us a little bit about what can parents expect from a newborn screening/developmental assessment, and why it’s important?

Dr. T. Jann Caison Sorey: This is very important because all of the baby’s systems, neurological, sensory-motor system, etc. develop from week-to-week. Neurologic, gross and fine motor skills change as the baby gets older and the developmental assessment is an excellent way to track this progression as a proxy.

Daniela: Thank you for the insight that you have shared with us today, Dr. Caison-Sorey. On a final note, what would be one piece of advice that you’d always give to parents-to-be as they prepare to welcome their baby?

Dr. T. Jann Caison Sorey: Be prepared. Your life is going to change. Prepare your home with the essentials and educate yourself, so you know what to expect. Find a pediatrician you can build a trusting relationship with before the baby is born and familiarize yourself with what to do if a worrisome situation arises – know your doctor’s after-hours number and location of the closest urgent care center or hospital in case of an emergency. It is helpful to know infant CPR. I also recommend having a close friend or family member who parents children close in age to your child, who can be a friendly listening ear.

Daniela: Thank you, Dr. Caison Sorey, and many thanks for your time today. The information you have shared with us will be very helpful to parents-to-be on their journey.

Dr. T. Jann Caison Sorey: Thanks so much, Daniela. Glad to share this information with new parents.

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